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Glutamine-enriched parenteral nutrition during postoperative catabolic state

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Background

Previous clinical studies led to the hypothesis that glutamine-enriched total parenteral nutrition (TPN) has beneficial effects on clinical course and on changes in the immune system of patients in postoperative catabolic state.

Patients and methods

20 patients with esophageal carcinoma were enrolled in a controlled, prospective, randomized and double-blinded study after esophageal resection: 10 patients received glycyl glutamine-enriched (0.15 g glutamine/kg/d) TPN (Glamin®, Baxter Inc.) from day 2 postoperatively, 10 patients served as control (TPN without glycyl-glutamine: Vamin®, Fresenius Inc). Clinical scores and immunological parameters were observed before and during the first 8 days after surgery. Lymphocyte subpopulations were measured using flow cytometry analyses (FACS-Flow®, Becton Dickinson), plasma cytokine levels were determined using standard ELISA technique.

Results

No significant differences were found, neither in clinical nor in immunological parameters: SAPS II scores as well as GORIS scores showed similar courses in both groups and ICU-days did not differ. Postoperative alterations of the immune system, measured by plasma IL-6 and procalcitonin levels as well as changes in lymphocyte counts and T4-T8-ratio, were nearly similar.

Conclusion

A beneficial effect of glutamine-enriched TPN could not be found in our study population. Further investigations are necessary to find out if higher doses and/or other patient groups are able to demonstrate similar effects as shown in former studies.

Acknowledgement

Supported by Baxter Inc., Munich, Germany.

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Ahlers, O., Harndt, K., Hodek, R. et al. Glutamine-enriched parenteral nutrition during postoperative catabolic state. Crit Care 4, P168 (2000). https://doi.org/10.1186/cc888

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Keywords

  • Flow Cytometry Analysis
  • Total Parenteral Nutrition
  • Esophageal Carcinoma
  • Procalcitonin
  • Lymphocyte Subpopulation